Effects of Resistance Exercise with Instability on Cognitive Function (REI Study): A Proof-Of-Concept Randomized Controlled Trial in Older Adults with Cognitive Complaints

Article type: Research Article

Authors: Cavalcante, Bruno Remígio^{a; b; d; *} | de Souza, Mariana Ferreira^{c; d} | Falck, Ryan Stanley^{e; f; g} | Liu-Ambrose, Teresa^{e; f; g} | Behm, David G.^h | Pitangui, Ana Carolina Rodarti^{b; i} | de Araújo, Rodrigo Cappato^{b; i}

Affiliations: [a] Associated Graduate Program in Physical Education UPE/UFPB, University of Pernambuco, Recife-PE, Brazil | [b] Laboratório de Pesquisa em Saúde e Desempenho Funcional (LABSED), University of Pernambuco, Petrolina-PE, Brazil | [c] Post-graduate Program in Physical Education, Federal University of Vale do São Francisco, Petrolina-PE, Brazil | [d] Clinic Exercise Lab (LABEC), Federal University of Vale do São Francisco, Petrolina-PE, Brazil | [e] Department of Physical Therapy, University of British Columbia (UBC), Vancouver, Canada | [f] Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, Canada | [g] Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada | [h] School of Human Kinetics and Recreation, Memorial University of Newfoundland St. John’s, NL, Canada | [i] Graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina-PE, Brazil

Correspondence: [*] Correspondence to: Bruno Remígio Cavalcante, PhD candidate, Associated Graduate Program in Physical Education UPE/UFPB, University of Pernambuco-UPE, Campus Petrolina, Address: BR 203 Km 02 s/n, Cidade Universitária, Vila Eduardo, Petrolina-PE 56328-903, Brazil. Tel.: +55 81 99565-0390; E-mail: [email protected].

Abstract: Background:Activities which simultaneously challenge both physical and cognitive function are promising strategies for promoting cognitive function. Objective:To examine the effects of resistance exercise with instability and traditional resistance exercise compared with a health education control on cognitive function in older adults with cognitive complaints. Methods:Sixty-seven participants were randomized to either 12 weeks of thrice-weekly resistance exercise (RE = 23), RE with instability (REI = 22), or a weekly health education control (CON = 22). At each training session, RE and REI participants performed seven exercises for three sets and 10–15 repetitions. REI participants performed each exercise using instability devices. The primary outcome was a composite score of global cognitive function. Secondary outcomes included composite scores for cognitive sub-domains and physical function. Results:Most participants were women (REI: 77%; RE = 78%; CON = 77%; mean age of 71 years), and did not need transport to the intervention site. At completion, compared with CON, REI and RE did not significantly improve on global cognition or each cognitive sub-domain. Both exercise groups improved on the timed up and go (REI - CON: –1.6 s, 95% CI: [–2.6, –0.5]; RE - CON: –1.4 s, 95% CI: [–2.4, –0.5) and 1-RM (REI - CON: 24 kg, 95% CI: [11, 36]; RE - CON: 25 kg, 95% CI: [12, 37]). An exploratory contrast showed that compared with RE, REI promote greater gains on global cognition (2.20, 95% CI: [0.10, 4.31]) and memory (1.34; 95% CI: [0.15, 2.54]). Conclusion:REI did not substantially improve cognitive function but did promote physical function among older adults with cognitive complaints. However, compared with RE, REI improved global cognition and memory.

Keywords: Aging, cognitive impairment, exercise, physical performance, randomized controlled trial, resistance training

DOI: 10.3233/JAD-200349

Journal: Journal of Alzheimer's Disease, vol. 77, no. 1, pp. 227-239, 2020